Department of Otorhinolaryngology, National University of Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia.
Department of Otorhinolaryngology, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.
J Int Adv Otol. 2021 Jul;17(4):301-305. doi: 10.5152/iao.2021.0078.
Postoperative or post-traumatic canal restenosis in patients with external auditory canal (EAC) stenosis is a troublesome complication faced by many ear surgeons following canalplasty or meatoplasty. Many ear prostheses and surgical methods have been introduced to prevent the occurrence of such complication. Our aim in this study is to explore the feasibility of using modified non-fenestrated uncuffed tracheostomy tubes (TT) as postoperative stents after ear canal surgery.
Canalplasty or meatoplasty was performed under general anesthesia via the posterior auricular transcanal approach. The EAC diameter and length were measured and a non-fenestrated uncuffed TT of suitable size was fitted into the ear canal. The TT was then modified during fitting, to fit onto the concha. Patients were advised on the importance of compliance. The adequacy of the size of the EAC after the surgery was assessed during follow-ups.
A total of 3 patients (4 ears) were included in our study. Various sizes of TTs were fitted into their EAC following canalplasty or meatoplasty. All of them showed excellent postoperative outcome on follow up 2 years after the surgery, with no evidence of postoperative EAC stenosis.
Modified TT stent after canalplasty or meatoplasty is proposed as an excellent alternative in preventing restenosis of EAC in centers with limited resources.
外耳道狭窄患者行外耳道成形术或外耳道皮瓣成形术后发生管腔再狭窄是许多耳科医生面临的棘手问题。为预防该并发症的发生，人们引入了许多耳科假体和手术方法。本研究旨在探讨使用改良型无侧孔无套囊气管切开套管（tracheostomy tube，TT）作为耳后径路外耳道成形术后支撑物的可行性。
全身麻醉下经耳后径路行外耳道成形术或外耳道皮瓣成形术。测量外耳道直径和长度，选择合适大小的改良型无侧孔无套囊 TT 并插入外耳道。术中根据需要对 TT 进行塑形以贴合外耳道。术后嘱患者注意保持 TT 在位。随访评估手术前后外耳道直径的变化。
本研究共纳入 3 例（4 耳）患者。外耳道成形术后或外耳道皮瓣成形术后将不同型号 TT 插入外耳道。所有患者术后 2 年均获得良好效果，无外耳道狭窄发生。
在资源有限的中心，改良 TT 支架可作为预防外耳道成形术后再狭窄的有效替代方法。
